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Holly Hovan's picture

By Holly Hovan MSN, GERO-BC, APRN, CWOCN-AP

Lower extremity wounds manifest in a multitude of ways, with numerous causative or trigger factors. These types of wounds are often costly to treat, are frequently refractory, and have a high risk for recurrence. A comprehensive assessment and an evidence-based treatment plan, along with ongoing patient education and routine follow-up, are essential components of an effective plan of care.

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By Holly Hovan MSN, GERO-BC, APRN, CWOCN-AP

Intertriginous dermatitis (ITD), also referred to as intertrigo, is an inflammatory condition that affects opposing skin surfaces and can occur anywhere on the body where two surfaces are in contact. For example, the pannus or abdominal skin folds, inner gluteal cleft, and axillae are some common anatomical locations of ITD. Intertrigo is seen across care settings and is increasingly common in patients with diabetes, patients with obesity, and patients who need assistance with hygiene or self-care activities of daily living. ITD is thought to be caused by a combination of two factors: moisture trapping or overhydration of the skin and friction between opposing skin folds (skin rubbing against skin for a prolonged period of time). ITD may manifest as a linear tear at the base of a fold or a linear open area within an area of macerated skin. Tears may result from stretching of overhydrated or moist skin during routine skin assessments or from friction with cleansing.

Holly Hovan's picture

By Holly Hovan, MSN, GERO-BC, APRN, CWOCN-AP

Peripheral artery disease (PAD) is also known as lower extremity arterial disease (LEAD), peripheral arterial occlusive disease (PAOD), or arteriosclerosis obliterans. LEAD is a disease that impacts the circulatory system, specifically the arteries (narrowing, which can result in a decreased supply of blood flow to the limb), and can eventually lead to limb loss or amputations. It is important to bring awareness to LEAD and its diagnosis, treatment, and prevention to improve access to care and screenings and ultimately to prevent limb loss.

WoundSource Editors's picture

Diabetic foot ulcers (DFUs) may affect up to 25% of people with diabetes at some point in their lifetime. Once a person has developed a DFU, there is a 50% chance the ulcer will become infected. DFUs are also among the leading causes of amputation.2

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Dianne Rudolph's picture

By Dianne Rudolph, DNP, GNP-bc, CWOCN

In evaluating a patient with a wound on the foot, a question that often comes to mind is whether that wound is caused by pressure, diabetes mellitus (DM), ischemia, trauma, or a combination. For example, a patient with DM who happens to have an ulcer on the foot may have a diabetic foot ulcer (DFU) or possibly something else. One of the bigger challenges that many clinicians face is trying to determine the etiology of a foot ulcer. There has been a great deal of debate about DFUs and pressure injuries (PIs) on the feet of patients in terms of how to appropriately assess, classify, and treat them. The confusion and lack of evidence in differentiating between these two types of foot ulcers, particularly on the heel, can lead to misdiagnosis, which can increase both financial and patient-related costs.

Steven A. Kahn's picture

By Steven A. Kahn, MD

When treating severe burns, surgeons generally consider eschar removal to be the major factor and the top challenge in both initiating and planning for the optimal course of treatment for each patient. Before grafting, all devitalized tissue must be removed, leaving a wound bed of only healthy tissue. Some burn wounds are clearly full-thickness on initial examination, and some are clearly superficial, with relatively straightforward decision making. However, some wounds have an indeterminate depth and are more challenging. Deep partial-thickness, indeterminate-, and heterogenous-depth wounds require more complex decision making and/or a protracted interval to allow the wound to declare. Eschar removal is sometimes necessary to allow surgeons to assess the wound bed and confirm the depth and severity of certain burns. This, in turn, provides the insights a surgeon needs to determine the best course of treatment, including whether a patient must be treated with an autograft to cover a wound area.

WoundSource Editors's picture

Selection of a wound dressing requires a multifaceted approach. Currently, no dressing can meet all needs of a wound (infection prevention, promotion of re-epithelialization, moisture balance, etc.).1 Clinicians must weigh the benefits and drawbacks of the dressing or dressings chosen, to optimize wound healing. However, one aspect that is common to most wound dressings is the need for moisture balance to promote wound healing. To achieve this balance, an appropriate dressing must be chosen.

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The digital age is upon us, like it or not, ready or not. For the past few years, payers have incentivized, encouraged, reimbursed, and adopted various digital, remote monitoring systems and devices as a way to encourage providers to adopt more digital, remote methods. Although complete telehealth services were not reimbursed in all care settings in all Zip Codes by all payers throughout the United States at the beginning of 2020, many of the restrictions and barriers to provide nearly complete digital services were suddenly released in response to the needs of a nation in the throes of a pandemic.

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By Industry News

Malvern, PA – July 30, 2021 – WoundCon, the first and largest global virtual wound care conference, is proud to announce a new and innovative live event that is free to attend and offers 5.25 CME/CE credits. Biofilm-Based Wound Care is a virtual, hands-on skills workshop that will be presented with closed captioning in eight languages, including Chinese, Spanish, Italian, Portuguese, French, German, Polish and English.

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Holly Hovan's picture

By Holly Hovan, MSN, GERO-BC, APRN, CWOCN-AP

Refractory wounds comprise a significant worldwide health problem, affecting 5 to 7 million people per year in the United States alone, as discussed in previous blogs. Wounds that fail to heal not only impact quality of life, but also impose a significant physical, psychosocial, and financial burden. Additionally, individuals with refractory wounds often experience significant morbidity, and sometimes mortality. Wound infections and amputations are common in this population, and chronic conditions often exist as well.